Over the years, the American Heart Association has made outstanding contributions and numerous improvements to cardiopulmonary resuscitation and advanced cardiac life support guidelines. It is due to adequate use of resources and continuous research that millions of lives are saved in the United States. Such guidelines serve health care providers and other members of the healthcare team as a resource to ensure adequate and timely response to those individuals who experience cardiac or respiratory arrest.
However, according to AHA statistics, "More than 326,000 people in the US suffer out-of-hospital cardiac arrests each year. Statistics prove that if more people knew CPR, more lives could be saved" (American Heart Association, 2016). In other words, dissemination of knowledge on the matter has direct outcomes on increasing survival rates. Therefore, the guidelines and the implementation methods are on continuous review based on new evidence. It is important to provide those who suffer cardiac or respiratory arrest with timely services because delays could end up affecting the outcome of those who experience reversible damage.
Healthcare providers around the world have become informed on the benefits of updated competence and direct patient outcomes and quality of care. The American Heart Association has published the new 2015 cardiopulmonary resuscitation guidelines, where changes and updates are reflected in an effort to put the best available evidence in practice. The purpose of this review is to compare the 2015 AHA updates with historical evidence in an attempt to explicate the implications and limitations of pharmacology in advanced cardiac life support.
Table of Contents
Introduction
How the Phenomena Impacts Healthcare Delivery
How the Phenomena Impacts Nursing Care
Asystole and Pulseless Electrical Activity: Historical Context
Current Practice Guidelines for Asystole and Pulseless Electrical Activity
Ventricular Fibrillation and Pulseless Ventricular Tachycardia: Historical Context
Antiarrhythmics
2015 Guideline Updates
Amiodarone and Current ACLS Practice
Lidocaine
Implications of the Literature Review
Potential Research Questions
Objectives and Topics
This literature review aims to compare the 2015 American Heart Association (AHA) cardiopulmonary resuscitation guidelines with historical evidence to clarify the implications and pharmacological limitations within Advanced Cardiac Life Support (ACLS). The study explores how updated evidence-based practices influence patient outcomes and the standard of care for cardiac arrest.
- Evolution of AHA guidelines for cardiac and respiratory arrest
- Pharmacological interventions for asystole and pulseless electrical activity (PEA)
- Clinical role of antiarrhythmics like amiodarone and lidocaine in ventricular fibrillation
- Impact of evidence-based guidelines on nursing ethics and clinical decision-making
- Critical analysis of current research on drug efficacy and long-term neurological outcomes
Excerpt from the Book
How the Phenomena Impacts Nursing Care
Over the years, The American Heart Association has taken part in the development of measures to help ensure timely and accurate treatment and interventions for those who experience cardiac or respiratory arrest. By having a clear understanding of the guidelines on basic life support and advanced cardiac life support the nurse can build a strong foundation on tested evidence. Leading to improved patient outcomes in acute and non-acute care settings. Nursing is not a profession that can be defined easily because it is variable in nature. A nurse is the person most involved in the care of those experiencing a difficult time in their health. Nursing is also a profession that focuses on the care of all individuals within the community. However, in order to maintain professionalism in patient care it is essential to follow the code of ethics. As demonstrated in the A.H.A 2015 updates, ethics is greatly emphasized during critical decision periods.
By following the code of ethics and principles highlighted in the AHA updates, health care providers can make educated decisions with a foundation in positive patient outcomes. One of the most important rules that guide the nurse’s professional practice is the “Do no harm” principle. This principle serves physicians and nurses as a guide to primarily consider the patient’s well being above all. As stated by the American Nurses Association, “Clear, accurate, and accessible information is an essential element of safe, quality, evidence based nursing practice” (2014, para 2). In an attempt to maintain clarity, the AHA created algorhythms to help increase patient safety, promote better inter-professional communication and prevent delay of care in the general population and acute care settings.
Summary of Chapters
Introduction: Provides an overview of the American Heart Association's role in developing resuscitation guidelines and the necessity of disseminating evidence-based knowledge to improve survival rates.
How the Phenomena Impacts Healthcare Delivery: Discusses the shift in healthcare delivery where medical research and technology empower patients, increasing the awareness of CPR and ACLS standards.
How the Phenomena Impacts Nursing Care: Examines the role of nurses in implementing evidence-based guidelines while adhering to the "Do no harm" ethical principle.
Asystole and Pulseless Electrical Activity: Historical Context: Reviews the evolution of guidelines for non-shockable rhythms, specifically detailing the historical recommendations for epinephrine and vasopressin.
Current Practice Guidelines for Asystole and Pulseless Electrical Activity: Analyzes the 2015 updates, highlighting the removal of vasopressin and the emphasis on early epinephrine administration.
Ventricular Fibrillation and Pulseless Ventricular Tachycardia: Historical Context: Details the primary importance of early electrical defibrillation in treating shockable cardiac rhythms.
Antiarrhythmics: Summarizes the recommendation of amiodarone as the first-line antiarrhythmic and lidocaine as an alternative in ACLS protocols.
2015 Guideline Updates: Outlines the key protocol changes in the 2015 guidelines, including the discontinuation of vasopressin and current stance on antiarrhythmic usage.
Amiodarone and Current ACLS Practice: Evaluates experimental evidence regarding amiodarone's efficacy in improving ROSC and survival rates.
Lidocaine: Explores clinical studies regarding the effectiveness of lidocaine compared to amiodarone and saline in resuscitation and cardiac surgery scenarios.
Implications of the Literature Review: Synthesizes the importance of competence in updated guidelines and the need for further hospital-based research.
Potential Research Questions: Proposes future directions for research regarding the long-term neurological and systemic effects of ACLS medications.
Keywords
American Heart Association, Cardiopulmonary Resuscitation, Advanced Cardiac Life Support, Epinephrine, Amiodarone, Lidocaine, Vasopressin, Cardiac Arrest, Asystole, Pulseless Electrical Activity, Nursing Ethics, Evidence-Based Practice, Patient Outcomes, Resuscitation Protocols, Clinical Decision-Making
Frequently Asked Questions
What is the core focus of this publication?
The work focuses on reviewing and contrasting the 2015 American Heart Association guidelines with historical evidence regarding pharmacological interventions in Advanced Cardiac Life Support.
Which specific conditions does the text cover?
It addresses asystole, pulseless electrical activity (PEA), ventricular fibrillation, and pulseless ventricular tachycardia.
What is the primary goal of this research review?
The primary goal is to explain the clinical implications and pharmacological limitations of the medications recommended in the 2015 AHA guidelines for cardiac arrest treatment.
What methodology is employed in the work?
The author performs a literature review, analyzing systematic reviews, meta-analyses, and clinical trials to evaluate the efficacy of drugs like epinephrine, amiodarone, and lidocaine.
What main topics are discussed in the body of the text?
The body covers historical contexts of resuscitation guidelines, the impact on healthcare and nursing care, specific pharmacological shifts, and the evaluation of drug efficacy.
Which keywords best characterize this work?
Key terms include ACLS, AHA guidelines, pharmacological resuscitation, epinephrine, antiarrhythmics, evidence-based nursing, and cardiac arrest survival.
Why was vasopressin removed from the latest ACLS algorithms?
The AHA removed vasopressin because studies showed no clear advantage when used as a substitute for epinephrine, and its removal simplifies the resuscitation algorithm.
What concern is raised regarding the use of epinephrine in cardiac arrest?
Research mentioned in the text suggests that while epinephrine may increase short-term survival, it might be associated with negative long-term neurological outcomes and microvascular blood flow reductions.
How do current guidelines influence nursing practice?
The guidelines provide a standard of care that supports nurses in making educated, ethical decisions based on the "Do no harm" principle, ultimately improving patient outcomes.
- Citation du texte
- Patrick Kimuyu (Auteur), 2017, Updates of the ACLS Guidelines 2015. A Historical Comparison, Munich, GRIN Verlag, https://www.grin.com/document/384456
